Intraocular foreign bodies, or FB, are usually the result of penetrating traumatic wounds that may land the FB into either the anterior or posterior chamber, depending upon the type of injury. Isolated intralenticular foreign bodies are rarely seen, and they soon lead to cataract formation. Some cases have been reported in peer literature about asymptomatic foreign bodies lying in the normal crystalline lens.
The FB may be metallic or non-metallic, and depending upon the constitution, the management protocol varies. The intralenticular FB may occasionally remain silent with no inflammatory response. The management protocol along with the type of surgical intervention depends upon the type of inflammatory response induced in the eye by the FB.
This video depicts an intralenticular FB with a sealed corneal tear and a sealed anterior capsule. The anterior capsule is stained with trypan blue, and the capsulorrhexis is initiated so as to involve the anterior capsular tear into the capsulorrhexis rim. The capsulorrhexis runs into the periphery, and a second attempt to make a rhexis is done by initiating it in the opposite direction. The peripherally extended flap is cut with micro-scissors, and the capsular flap is removed. Hydrodelineation is performed, and the FB is prolapsed into the anterior chamber. An ophthalmic viscosurgical device is injected beneath the FB to help it float in the anterior chamber. The FB is grasped with end-opening forceps and is removed from the eye. The phaco procedure is then performed, and a one-piece foldable IOL is placed in the capsular bag. Anterior capsular polishing is performed to remove all the anterior peripheral epithelial cells. Irrigation-aspiration is performed, and stromal hydration is done. Postoperatively, the patient regained 6/6 vision on the Snellen visual acuity chart.